Active NPI
Harry Manfred Suekert, DDS
- Dentist
- Chattanooga, TN
National Provider Identifier
1750390241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS0000008664
- Practice address
- 3500 Ringgold Rd
Suite 1
Chattanooga, TN 37412-1271 - Phone
- (423) 698-8651
- Fax
- (423) 698-4692
- NPI assigned
- Aug 5, 2006
- Last updated
- Jun 30, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901015953 | MI | |
| Dentist | 122300000X | DS0000008664 | TN | Primary |
| Dentist | 122300000X | 57093 | CA |
Addresses
Primary practice location
3500 Ringgold Rd
Suite 1
Chattanooga, TN 37412-1271
Mailing address
3500 Ringgold Rd
Suite 1
Chattanooga, TN 37412-1271
Phone (423) 698-8651
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159530 | Other | MI | BC/BS DENTAL |
| 1951560080 | Other | MI | BC/BS MEDICAL |
| 38-3340423 | Other | MI | FED TAX ID # |
| 26-2420642 | Other | TN | FED TAX ID |
| 15953 | Other | MI | DELTA DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57093 | CA | MD | Dentist |
| 2901015953 | MI | MD | Dentist |
| DS0000008664 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1750390241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 RINGGOLD RD",
"address_2": "SUITE 1",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374121271",
"telephone_number": "423-698-8651",
"fax_number": "423-698-4692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 RINGGOLD RD",
"address_2": "SUITE 1",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374121271",
"telephone_number": "423-698-8651",
"fax_number": "423-698-4692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUEKERT",
"first_name": "HARRY",
"middle_name": "MANFRED",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901015953",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "DS0000008664",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57093",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS DENTAL",
"identifier": "159530",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS MEDICAL",
"identifier": "1951560080",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID #",
"identifier": "38-3340423",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "26-2420642",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "15953",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.